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1. Would you like your details to be added to our contact list for REEN members?

***The list will be available on a password-protected website***
(Required.)

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2. Your name
(Required.)

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3. Your role
(Required.)

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4. Your school/ service
(Required.)

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5. Your email

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6. Your phone number

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7. What topics are you most interested in REEN advocating about?

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8. Would you like your advocacy topics of interest (question 7) to be included on our shared contact list?

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9. Are you interested in being contacted when opportunities arise to contribute to advocacy about these topics?

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